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Avondstondt AM, Ezzedine D, Salamon C. Perineal hernia repair using permanent suture and mesh: a video case presentation. Int Urogynecol J 2019; 30:1981-1983. [PMID: 31139857 DOI: 10.1007/s00192-019-03956-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Perineal hernias are an uncommon cause of pelvic bulge symptoms in women with no established ideal surgical approach. We present the case of a posterior perineal hernia repaired robotically using permanent sutures and mesh. METHODS A 67-year-old woman with a posterior perineal hernia and stage III uterovaginal prolapse presented to our office and underwent minimally invasive robotics-assisted abdominal surgery. Her levator plate defect was closed primarily using permanent sutures and reinforced using polypropylene mesh. A concomitant supracervical hysterectomy and sacrocolpopexy were performed. RESULTS Robotics-assisted transabdominal perineal hernia repair offered excellent intra-operative visualization and complete delineation of the defect. CONCLUSIONS Robotics-assisted abdominal primary repair of the perineal hernia and overlying mesh placement offered a safe and effective repair of this rare disorder.
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Affiliation(s)
- Andrea M Avondstondt
- Department of Urogynecology and Reconstructive Surgery, Atlantic Health System, 435 South St. Suite #370, Morristown, NJ, 07940, USA.
| | - Dima Ezzedine
- Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA
| | - Charbel Salamon
- Department of Urogynecology and Reconstructive Surgery, Atlantic Health System, 435 South St. Suite #370, Morristown, NJ, 07940, USA
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Li J, Zhang W. How we do it: repair of large perineal hernia after abdominoperineal resection. Hernia 2017; 21:957-961. [PMID: 29027023 DOI: 10.1007/s10029-017-1685-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 10/06/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Symptomatic perineal hernia is a rare complication after abdominoperineal resection (APR). Management of these hernias is challenging. The recurrence rate after surgical repair is high because of the difficulty of prosthetic material fixation; there is no consensus regarding the best method of repair. METHODS We introduced a novel combined laparoscopic-perineal dual fixation technique in the repair of perineal hernias after APR. This technique begins with a perineal approach under laparoscopic vision. After excision of the hernia sac, the mesh is introduced and fixed anteriorly to the urogenital diaphragm and laterally to the sacrotuberous ligament and the surrounding scar tissue. The perineal incision is then closed. Next, the mesh is fixed to the sacrum with ProTack® and is fixed again to the sacrotuberous ligament via a laparoscopic approach. RESULTS The dual fixation repair method is successful and without difficulties, with no recurrence at 13-month follow-up. CONCLUSION Our laparoscopic-perineal dual fixation method is a good alternative method for large perineal hernia repair after APR.
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Affiliation(s)
- J Li
- Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China.
| | - W Zhang
- Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China
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Alvarez Garzón HJ, Maubon T, Jauffret C, Vieille P, Fatton B, de Tayrac R. Synthetic mesh repair of an anterior perineal hernia following robotic radical urethrocystectomy. Int Braz J Urol 2017; 43:982-986. [PMID: 28537698 PMCID: PMC5678534 DOI: 10.1590/s1677-5538.ibju.2016.0534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/11/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction: Perineal hernia is a protrusion of intra-abdominal viscera through a defect in the pelvic floor and is a rare but challenging complication after extensive abdominoperineal surgery. There have been small series published after colorectal exenteration, but no cases have been reported after radical cystectomy and urethrectomy. Case Presentation: A 68 years old woman developed an anterior perineal hernia, with no vaginal prolapse, after an anterior exenteration for bladder cancer. A perineal approach with the use of a synthetic polypropylene mesh was chosen to resolve the condition. After 6 months of follow-up, the patient has no symptoms or recurrence of the anterior perineal hernia. Conclusion: To our knowledge, this case is the first report of perineal hernia after radical urethrocystectomy. Although being a case report, this article describes a potential and challenging complication after extensive anterior pelvic surgery, that could increase its incidence in the future. Literature review shows that whether perineal, abdominal or combined approach is chosen, surgery must respect hernia repair principles.
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Affiliation(s)
- Horacio J Alvarez Garzón
- Department of Urology, Hospital Privado Centro Medico de Córdoba, Argentina.,Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France
| | - Thomas Maubon
- Department of Urology and Surgical Oncology, Institut Paoli Calmettes, Marseille, France
| | - Camille Jauffret
- Department of Urology and Surgical Oncology, Institut Paoli Calmettes, Marseille, France
| | - Pierre Vieille
- Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France
| | - Brigitte Fatton
- Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France
| | - Renaud de Tayrac
- Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France
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Abstract
Traumatic or postsurgical flank hernias are complex and prone to recurrence, particularly at the border of the iliac crest. We reviewed our experience using suture anchors drilled into the iliac crest to fixate the mesh to bone. Our study of 10 repairs in eight patients was Institutional Review Board exempt. We obtained demographics, body mass index, diabetes, methicillin-resistant Staphylococcus aureus (MRSA) history, smoking status, steroid use, number of prior repairs, defect size, mesh size, number of anchors, and recurrence and infection at follow-up. We performed Kaplan-Meier analysis using a composite of recurrence or infection. Three of eight (interquartile range, 37.5%) patients were male. Median age and body mass index were 47.5 years (31.0, 54.7) and 32.2 (29.0, 36.0), respectively. Three patients had prior repairs, one each with two, three, and five prior attempts at fixation. One of eight patients (12.5%) had a history of MRSA infection. One of eight patients (12.5%) had a history of intermittent steroid use for sarcoidosis. Defect size was 90 cm2 (62.2, 165) and mesh size was 155 cm2 (150, 232) with four anchors (4, 5.5). Procedural complications included 2/10 (20%) with recurrence and 1/10 (10%) with postoperative MRSA infection. Follow-up was 12 months (3.0, 25.0). Mean freedom from recurrence and mesh infection (Kaplan-Meier) was 43.5 months (95% confidence interval = 24.2, 62.8). In conclusion, our series is one of the largest in the literature involving the suture anchor technique. Despite a high-risk patient population due to trauma, obesity, and prior smoking and MRSA history, we achieved an acceptable recurrence rate. Further study may benefit from a randomized trial design.
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Affiliation(s)
- Kaushik Mukherjee
- Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Richard S. Miller
- Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee
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Narang SK, Alam NN, Köckerling F, Daniels IR, Smart NJ. Repair of Perineal Hernia Following Abdominoperineal Excision with Biological Mesh: A Systematic Review. Front Surg 2016; 3:49. [PMID: 27656644 PMCID: PMC5011127 DOI: 10.3389/fsurg.2016.00049] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 08/22/2016] [Indexed: 01/30/2023] Open
Abstract
Introduction Perineal hernia (PerH) following abdominoperineal excision (APE) procedure is a recognized complication. PerH was considered an infrequent complication of APE procedure; however, PerH rates of up to 45% have been reported in recent publications following a laparoscopic APE procedure. Various methods of repair of PerH with the use of synthetic meshes or myocutaneous flap have been described, although there is no general agreement on an optimal strategy. The use of biological meshes for different operations is growing in popularity, and these have been promoted as being superior and safer when compared to synthetic meshes. Although the use of biologics is becoming popular claims of better outcomes are largely unsupported by evidence. The aim of this systematic review is to evaluate the currently available evidence supporting the use of biologic or biosynthetic meshes for the repair of PerH that develop following an APE. Methods A systematic review of all English language literature relevant to repair of PerH following APE with biologic or biosynthetic mesh published between January 1, 2000 and July 31, 2016 was carried out using MEDLINE, EMBASE, and the Cochrane Library of Systematic Reviews for relevant literature. Searches were performed using a combination of Medical Subject Headings (MeSH) terms and text words “PerH,” “APE,” “morbidity,” “biologics,” “biosynthetic,” and “hernia.” Studies in which the use of biological meshes was not reported were excluded from the review. Various outcome measures, including operative technique, complication rates, recurrence rates, type of mesh, management of recurrences, and risk factors, were extracted. Oxford Centre for Evidence-based Medicine – Levels of Evidence (March 2009) was used to assess the quality of evidence. Results The systematic review of the literature identified three case reports, four case series, and one pooled analysis that were included in the final review. Overall, these studies were of poor quality providing level 4 evidence. Various different approaches and techniques of repair of PerH were described; however, it was difficult to extract information with regard to the primary and secondary outcome measures. Conclusion There is no general agreement to the optimal operative strategy to repair PerH following an APE. There is insufficient evidence to recommend any specific operative approach or repair technique for PerH following an APE.
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Affiliation(s)
- Sunil K Narang
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter Hospital , Exeter, Devon , UK
| | - Nasra N Alam
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter Hospital , Exeter, Devon , UK
| | - Ferdinand Köckerling
- Department of Surgery, Center for Minimally Invasive Surgery, Vivantes Hospital, Academic Teaching Hospital of Charité Medical School , Berlin , Germany
| | - Ian R Daniels
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter Hospital , Exeter, Devon , UK
| | - Neil J Smart
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter Hospital , Exeter, Devon , UK
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Abstract
Purpose This study aimed to determine the outcome of perineal hernia repair with a biological mesh after abdominoperineal resection (APR). Method All consecutive patients who underwent perineal hernia repair with a porcine acellular dermal mesh between 2010 and 2014 were included. Follow-up was performed by clinical examination and MRI. Results Fifteen patients underwent perineal hernia repair after a median of 25 months from APR. Four patients had a concomitant contaminated perineal defect, for which a gluteal fasciocutaneous flap was added in three patients. Wound infection occurred in three patients. After a median follow-up of 17 months (IQR 12–24), a clinically recurrent perineal hernia developed in 7 patients (47 %): 6 of 11 patients after a non-cross-linked mesh and 1 of 4 patients after a cross-linked mesh (p = 0.57). Routine MRI at a median of 17 months revealed a recurrent perineal hernia in 7 of 10 evaluable patients, with clinical confirmation of recurrence in 5 of these 7 patients. No recurrent hernia was observed in the three patients with combined flap reconstruction for contaminated perineal defects. Conclusion A high recurrence rate was observed after biological mesh repair of a perineal hernia following APR.
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Blair LJ, Cox TC, Huntington CR, Ross SW, Kneisl JS, Augenstein VA, Heniford BT. Bone Anchor Fixation in Abdominal Wall Reconstruction: A Useful Adjunct in Suprapubic and Para-iliac Hernia Repair. Am Surg 2015. [DOI: 10.1177/000313481508100718] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Suprapubic hernias, parailiac or flank hernias, and lumbar hernias are difficult to repair and are associated with high-recurrence rates owing to difficulty in obtaining substantive overlap and especially mesh fixation due to bone being a margin of the hernia. Orthopedic suture anchors used for ligament reconstruction have been used to attach prosthetic material to bony surfaces and can be used in the repair of these hernias where suture fixation was impossible. A prospective, single institution study of ventral hernia repairs involving bone anchor mesh fixation was performed. Demographics, operative details, and outcomes data were collected. Twenty patients were identified, with a mean age 53 (range: 35–70 years) and mean body mass index 28.4 kg/m2 (range 21–38). Ten lumbar, seven suprapubic, and three parailiac hernias were studied. The majority were recurrent hernias (n = 13), with one to seven previously failed repairs. The mean hernia defect size was very large (270 cm2; range: 56–832 cm2) with average mesh size of 1090 cm2 (range 224–3640 cm2). Both Mitek GII (Depuy, Raynham, MA) and JuggerKnot 2.9-mm (Biomet, Biomedical Instruments, Warsaw, IN) anchors were used, with an average of four anchors/case (range: 1–16). Mean operative time was 218 minutes (120–495). There were three minor complications, no operative mortality, and no recurrences during an average follow-up of 24 months. Pelvic bone anchors permit mesh fixation in high-recurrence areas not amenable to traditional suture fixation. The ability to safely and effectively use bone anchor fixation is an essential tool in complex open ventral hernia repair.
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Affiliation(s)
- Laurel J. Blair
- Department of Surgery, Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Tiffany C. Cox
- Department of Surgery, Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Ciara R. Huntington
- Department of Surgery, Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Samuel W. Ross
- Department of Surgery, Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Jeffrey S. Kneisl
- Department of Surgery, Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Vedra A. Augenstein
- Department of Surgery, Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - B. Todd Heniford
- Department of Surgery, Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina
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Elkwood AI, Borao FJ, Ashinoff RL, Kaufman MR, Rose MI, Kharod AS, Binenbaum SJ, Cece J, Patel TR, Otake LR. Complex incisional hernias repaired in conjunction with the Bony Anchoring Reinforcement System (BARS) prevents hernia recurrence. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-0961-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Repair of symptomatic perineal hernia with a titanium mesh. Hernia 2013; 18:587-90. [PMID: 23934356 DOI: 10.1007/s10029-013-1152-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 07/28/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Surgical repair of symptomatic perineal hernia is challenging, especially via a perineal approach with limited exposure of the hernia sac. Furthermore, insecure fixation of autologous or synthetic materials to bony structures often results in recurrence. Here, we describe the application of a titanium mesh for perineal hernia repair. METHODS We performed hernia repair with a thin titanium mesh via a perineal approach in three patients who developed secondary perineal hernia following abdominoperineal resection. After the hernia sac was isolated and dissected, the titanium mesh was molded and placed over the ischium and coccyx to support the pelvic floor. RESULTS No major complications occurred, and all three patients were free of recurrence at follow-up after 73, 109, and 6 months, respectively. The patients experienced slight pain in the perineal region when sitting, which resolved within 6 months. CONCLUSION Our successful preliminary results indicate that a titanium mesh is useful for perineal hernia repair by the perineal approach, as it can provide rigid support for the pelvic floor by its entire surface while ensuring stability without any fixation.
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Saad A, Cece JA, Arvanitis ML, Elkwood AI. The use of bone anchors for autologous flap fixation in perineal reconstruction: a case report. J Surg Case Rep 2013; 2013:rjt063. [PMID: 24964462 PMCID: PMC3813751 DOI: 10.1093/jscr/rjt063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The purpose of this case report is to demonstrate the use of bone anchors with an autologous flap in perineal reconstruction. This technique has not been reported before. A 64-year-old female presented to our office with a chief complaint of perineal hernia 1.5 years after abdominoperineal resection. She had a history of recurrent rectal cancer for which she received chemotherapy, radiation and surgery. To repair the hernia, a standard vertical rectus abdominismyocutaneous was harvested and de-epithelialized. It was secured into place in the pelvis utilizing several bone anchors. Mesh was used to repair the donor site defect. At 18 month follow-up, there was good healing of all the wounds and no recurrence of the hernia. She was pain free and able to resume her activities of daily living. Bone anchor fixation is a viable technique for fixation of autologous flaps in perineal reconstruction.
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Affiliation(s)
- Adam Saad
- The Institute for Advanced Reconstruction at The Plastic Surgery Center, Shrewsbury, NJ, USA
| | - John A Cece
- The Institute for Advanced Reconstruction at The Plastic Surgery Center, Shrewsbury, NJ, USA
| | - Michael L Arvanitis
- Division of Colon and Rectal Surgery, Monmouth Medical Center, Long Branch, NJ, USA
| | - Andrew I Elkwood
- The Institute for Advanced Reconstruction at The Plastic Surgery Center, Shrewsbury, NJ, USA
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Chen X, Feng X, Xie J, Ruan S, Lin Y, Lin Z, Shen R, Zhang F. Application of acellular dermal xenografts in full-thickness skin burns. Exp Ther Med 2013; 6:194-198. [PMID: 23935745 PMCID: PMC3735587 DOI: 10.3892/etm.2013.1114] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 04/11/2013] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to explore the clinical value of the porcine acellular dermal xenograft (ADX) in combination with autologous split-thickness skin and pure autologous split-thickness skin grafting applied in deep full-thickness burns and scar wounds. A total of 30 patients with deep burns were randomly divided into experimental and control groups following escharectomy. The patients were separately treated with porcine acellular dermal xenograft (ADX) in combination with autologous split-thickness skin and pure autologous split-thickness skin graft. The wound healing was observed routinely and the scores were evaluated using Vancouver scar scale at different times following transplant surgery. The samples of cograft regions and the control group (pure transplant split-thickness skin autograft) were observed using light microscopy and electron microscopy, and the follow-up results were recorded. No conspicuous rejections on the cograft wound surface were observed. Compared with the control group, the cograft wounds were smooth, presented no scar contracture and exhibited good skin elasticity and recovery of the joint function. The cografted skin combined well and displayed a clear and continuous basal membrane, as well as gradually combined skin structure, a mature stratum corneum, downward extended rete pegs, a mainly uniform dermal collagen fiber structure, regular alignment, and fewer blood capillaries. Clear desmosome cograft regions were identified among heckle cells, as well as a clear and continuous basal membrane. The cografted skin of the combined split-thickness autograft and the acellular heterologous (porcine) dermal matrix showed an improved shape and functional recovery compared with the pure split-thickness skin autograft. The combination of the meshed ADX and the split-thickness skin autograft applied in deep full-thickness burns and scar wounds may induce tissue regeneration via dermis aiming. This method also has superior shape and functional recovery, and has an extensive clinical application value.
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Affiliation(s)
- Xiaodong Chen
- Department of Burns Surgery, The First People's Hospital of Foshan, Foshan, Guangdong 528000
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The use of the Mitek anchoring system on the iliac crest for flank incisional hernia repair. EUROPEAN JOURNAL OF PLASTIC SURGERY 2012. [DOI: 10.1007/s00238-012-0793-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mjoli M, Sloothaak DAM, Buskens CJ, Bemelman WA, Tanis PJ. Perineal hernia repair after abdominoperineal resection: a pooled analysis. Colorectal Dis 2012; 14:e400-6. [PMID: 22308975 DOI: 10.1111/j.1463-1318.2012.02970.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM The purpose of this study was to determine treatment characteristics and clinical outcome for patients with perineal hernia after abdominoperineal excision (APE). METHOD A systematic search of the literature revealed 40 individually documented patients, published between 1944 and 2010. Three additional patients treated at our centre were added. Patient characteristics, type of repair and outcome were entered into a database and a pooled analysis of these 43 patients was performed. RESULTS The pooled analysis revealed a median time interval of 8 months between APE and surgical repair of perineal hernia. The surgical approaches were perineal in 22 patients, open abdominal in 11, open abdominoperineal in three, laparoscopic in five and laparoscopic-perineal in two patients. A primary recurrence was documented in 13 patients and a second recurrence in three. The recurrence rate was 5/25 for synthetic or biological mesh, 6/12 for primary closure and 2/6 for the remaining techniques. Recurrent perineal hernia was repaired using a synthetic or biological mesh (n = 6), primary closure (n = 5) or a muscle flap (gluteus or gracilis; n = 4). CONCLUSION From these limited and biased data based on published case descriptions, it appears that the recurrence rate of primary perineal hernia repair after APE is lower with the use of a mesh or other assisted closure than with primary suture repair.
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Affiliation(s)
- M Mjoli
- Department of Surgery, Pietermaritzburg Hospital Complex, University of KwaZulu Natal, Durban, South Africa
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Rodriguez Y, Casey B, Bazan RE, Zeidan R, Tsikis J, Cardella IA. Recurrent Perineal Hernia After Benign Pelvic Reconstructive Surgery. J Gynecol Surg 2012. [DOI: 10.1089/gyn.2011.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yasser Rodriguez
- University of Michigan Health Systems, Ann Arbor, Michigan
- University of Miami Miller School of Medicine, Miami, Florida
| | - Brittany Casey
- University of Miami Miller School of Medicine, Miami, Florida
| | | | - Rita Zeidan
- University of Miami Miller School of Medicine, Miami, Florida
| | - Joanna Tsikis
- University of Miami Miller School of Medicine, Miami, Florida
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Ong SL, Miller AS. A transperineal approach to perineal hernia repair using suture anchors and acellular porcine dermal mesh. Tech Coloproctol 2011; 17:605-7. [PMID: 22108954 DOI: 10.1007/s10151-011-0774-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Accepted: 10/08/2011] [Indexed: 11/26/2022]
Abstract
Perineal hernia following major pelvic surgery is a rare but recognised complication. Various surgical approaches to the repair of a symptomatic perineal hernia have been described. We describe the first reported use of the Mitek suture anchors to secure an acellular porcine dermal graft to the ischia during the transperineal repair of a large perineal hernia.
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Affiliation(s)
- S L Ong
- University Hospitals of Leicester, Leicester, United Kingdom,
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